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AHLA's Speaking of Health Law
C-Suite Roundtable: Issues Related to Health Care Transformation
Rob Gerberry, Senior Vice President and Chief Legal Officer, Summa Health, speaks with Angela Brandt, Chief Administrative Officer, ProMedica Health System, and Daryl Tol, Transformation Leader, General Catalyst, about how health care organizations can navigate the continuing transformation of U.S. health care. They discuss some of the headwinds facing the health care industry and issues related to provider partnerships, artificial intelligence, payer mix, consolidation and integration, and the role lawyers can play in health care transformation.
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SPEAKER_02:Hello, everyone. Welcome to our latest in our C-Suite podcast series. I'm Rob Gerber. I'm the Chief Legal Officer of Summa Health and the President-Elect Designate of HLA. I'm excited to welcome two esteemed guests today to our podcast, Angela Brandt and Daryl Till. I'm going to start with them providing introductions. So Angela.
SPEAKER_01:Hi, well, welcome, or welcome to everyone who's joining anyway. I'm Angela Brandt. I'm the Chief Administrative Officer for ProMedica Health System. ProMedica is headquartered in Toledo, Ohio, and we're an integrated healthcare delivery system that has 10 hospitals, a large employed network of providers. And as the Chief Administrative Officer, I oversee all of our corporate shared services and help to lead our strategic transformation and strategic planning. So So looking forward to the discussion today.
SPEAKER_03:Excellent.
UNKNOWN:Daryl.
SPEAKER_03:Hey, hi, everybody. Daryl Toll. I'm a recovering health system CEO. I've spent years at AdventHealth in Florida, and now I'm leading our transformation efforts at General Catalyst and with our new company called HATCO, or the Health Assurance Transformation Company. So we're focusing on accelerating transformation with health systems, thinking about ways to actually drive change in healthcare that works for systems in the can be led by a regional healthcare system. So excited to join you all today.
SPEAKER_02:So in our prior episodes, we've had C-suite executives across several different disciplines share a lot of their challenges, their problems. These two guests were picked today because they're going to solve all those. No pressure at all, but they are both exceptional thought leaders in the healthcare space. So looking forward to sharing with our membership their thoughts. And so we're going to start with the open-ended question of there's lots of headwinds right now in the healthcare industry. that are further in the need for transformation and change. Angela and Daryl, just your initial thoughts on not only some of those macro trends, but what are some of the ways that our membership should start to think about the need to pivot from our current model and really build out a new system that could best serve our patients going
SPEAKER_01:forward? You wanna go first or I? That's a loaded
SPEAKER_03:question. Yeah, you know, it's interesting. I like to think about this idea anytime I hear someone say healthcare is broken. I remember a discussion where someone said, it's not broken, it was designed this way. And so in order to improve it, to fix it, to build resilience, to address the needs of the workforce, which is burning out and in short supply, it needs to be redesigned. So to me, the invitation of times of pressure, times of challenge. to dismantle a system that was built away that led to poorly aligned incentives, exhausting workflows, insecure environments, overly complex consumer experiences, and start to redesign them from the ground up. The good news is, psychologically, in order to change a Disappointment is required. Challenge is required. Burning platforms are required. So when everyone's fat and happy, it's very difficult to create the energy that's required to change a poorly designed system. And so my view is it's a time of great challenge and also great opportunity.
SPEAKER_01:I love that you just slipped it on its head because that's exactly the only place you're going to be able to fix it. I would... echo your conversations on headwinds. I think workforce challenges are difficult. People are burnt out. I know COVID was five years ago for the rest of the world and healthcare still feels like yesterday in many ways, but workforce shortages, changes in workforce, all of the workforce issues are a big deal. I know we continue to talk about care shifting to ambulatory, but I think there's also, that's disrupting too. It's not just ambulatory and healthcare. We have a lot of healthcare providers out there that are not hospitals or healthcare systems. So thinking about the disruption there makes us think about how we deliver care more efficiently and more broadly to people. And it also makes us more valuable in that inpatient experience, right? But we have to deliver a better customer experience. I love what you said. I mean, we have to do better than that for our consumers and for our We call them patients, right? But our patients are really just our friends, our families, our neighbors, our employees, and most of our systems. And so why wouldn't you want to deliver better care to those people you care about? I think the other thing I would add is aside of those rising consumer Expectations, we still have all the financial pressures that you were talking about, kind of the what's broken part, right? So the financial pressures from payer consolidation, inflation, supply chain disruptions. So that also allows for us to think about those headwinds and ways of how do we innovate? How do we transform?
SPEAKER_02:So, Ange, to your point, we're coming off four days of board meetings last week with our board, and they are saying it is five years later. So why are we still facing those same wage inflation issues, issues with payers around denials, this increase in farm and supply costs? Is anybody hearing us out there that we've got these challenges? So if we were to tell the government, who is right now having a lot of deliberations around health care, let's start blank. Let's have a blank sheet of paper and rebuild this. Any thoughts on what you might share?
SPEAKER_01:I mean, I can think of a couple of different things right off the top of my head. I mean, I do think this is not so much for the government question you just asked about. So I will get back to that in a moment. But I do think, how do we continue to prioritize our employee experience? Daryl was talking about that. How do we lean into technology to make things more efficient for our staff? The reason our staff is so burnt out, too, is that there are a lot of demands. We have technology in a lot of places, but we're still asking them to work really harder, not always smarter. So I think we can leverage technology in making things more efficient, leveraging predictive analytics, leveraging AI, leveraging automation. And that's true, too, even for the non-clinical setting. So healthcare needs to become more efficient in our administrative spaces as well. So I think that technology could be utilized there. If I were talking to the healthcare lawyers and everybody in DC or our advocacy side, I think using value-based care incentives or aligning incentives with our patients, thinking about care more as an interdisciplinary team that could be tech-enabled, how do we get people to buy into that kind of care just as much as we need to adopt it? We need our our patients to be excited about engaging with us in that way. So can we set up this incentives in a different way? I don't know, Darrell, what do you think?
SPEAKER_03:Yeah, I think those are all really good points. I also think we have an interesting challenge and opportunity that the current administration is unique. It's unique in a number of ways. certain leaders in core healthcare related areas think differently and respond to evidence differently than in prior administrations. So that gives us an interesting challenge to overcome to ensure that evidence continues to drive clinical practice and policy at the federal level But also the administration is very open and quick moving in spaces where you can capture their interests. Sometimes that's around something that's unique that could become a branded change made in this administration that could improve certain areas of strong support like rural markets that they're very sensitive to. So I think we can look at areas where this administration can move a lot more quickly with a lot less inertia that can, at the stroke of a pen almost, change the way healthcare functions, whereas prior administrations might move much more steadily, much more slowly. So if we can find some of those areas, I think we can create a flywheel effect if we do it thoughtfully as an industry. The other thing I would say is we hurt ourselves often. We hurt ourselves by fragmented advocacy. Every special interest group in healthcare comes with a different message. I would say hospitals and health systems largely come with the message, pay me more and or don't cut my payments, which isn't a very creative message. A creative message is the system today is broken and looks like this. We envision a system that's better that looks like this. That will require the following three to five changes in policy in order to facilitate the movement from this system to this new system. I don't see our advocacy efforts being that organized. I see us being reactive and reimbursement focused. Now to Angela's point, we do need to be reimbursed differently. We need to be reimbursed for innovative things that involve special kinds of virtual care, advanced care at home that doesn't have to pass an admission threshold, but might be a very significant post-acute opportunity that deals with the post-acute shortages we see around the country. Entirely new ways of structuring our systems of care that include virtual in-person, AI, human beings, and payment mechanisms that don't require the 14 encounters before you can and say you're doing X, Y, Z. Those are old constructs. And so I do think we need to put our heads together and think about what is the new construct we want to develop that's in the interest of consumers and patients in our workforce.
SPEAKER_02:Yeah, I think that's a great point. When I hear people talk in the advocacy world, it's all, we'll make sure that we all portray that we're strong. We're these large employers in our communities, the pillars of the community. But at the same time, we've got to share If we don't get what we need, there's going to be layoffs. There's going to be cuts to services. It's a real difficult balance, it seems like, right now for a lot of organizations as they face a lot of the financial headwinds. One of the challenges we also face is making sure that we as administrators bring our providers into partnership with us as we look to make some of these transformative changes. What strategies or techniques have you both utilized to make sure your physicians, your nurses, your physician assistants all feel a part of this change with you?
SPEAKER_03:I think part of the COVID dynamic that really opened my eyes is at some point I realized that in healthcare, the building is on fire. And it certainly felt like it was on fire during COVID. And we were going to our teams and saying, yes, it's on fire, but Come on in anyway. Come in and work here. And then we really scratched our heads as an industry. Why are people always wanting more money? And, well, wait a minute. If you're asking someone to go into a building that's on fire and the fire hasn't been put out, the underlying conditions of the fire have not been addressed, the fuel's not been addressed, then people are going to say, how much are you going to pay me to go in there? It's a very natural set of reactions. And I think we have to change that entire storyline to be fair. I think we need to understand why is it so difficult? Going into COVID, in 2019, Deloitte did a study of hundreds of nurses, critical care nurses. Over 50% of them rated their mental health of five or lower on a scale of one to 10. And over 60%, rated their physical health a five or lower on a scale of one to 10. So those are the people we brought into COVID. And then you can imagine the energy burn and the fear burn and the moral injury that has happened through COVID. So how do we reset? I think an important way to reset is one, create highly collaborative groupings of specially trained individuals that can help us build the system of the future. In a prior organization, we created a group of physicians. Someone told me once the square root of N is how you create change in an organization. You have to engage and get enthusiasm and energy from the square root of the population you're trying to change. So if you have thousands of doctors, you need hundreds of doctors to join you. and they need to be part of planning and they need to feel energetic and they need to feel inspired. So we created a group called The Catalysts, 200 doctors, and they joined in strategic planning and they came to all leadership meetings and they were not elected. They were appointed and selected because they were passionate physicians who wanted to drive to the future and had a vision for the future in their specialty and for the organization. I've never seen change happen so substantially than I saw from that group. Each physician in that 200 was given an assignment of seven to 10 other doctors that their goal was to share this with those physicians and to energize and create excitement or at least talk through with them their disenchantment. And slowly, steadily, the ripples grew from that. We need to do that with doctors. We need to do that with nurses. But even so, So even more substantively, the way work is designed in healthcare is very harmful. It's very harmful. The incentives are misaligned. The structures are poorly set. We're largely analog organizations that have glued technology on without redesigning people and processes to accept that technology. We've glued our electronic health records on. We've glued other technologies. In most systems, it's hundreds of technologies onto a largely analog system. That means we have people who literally still today pull papers off of fax machines and type in what the paper says into the computer. We have those systems all over healthcare, and it's a very frustrating career if you think about it. Moving a paper from a fax machine and typing it into the computer is not what you dreamt about when you were a child. You want to do something big and purpose-driven and heroic, and we're giving people these broken down jobs to do that over time really need to be redeveloped. That's harder than creating a group of catalysts, but that's an outcome I think we should all seek.
SPEAKER_01:Yeah, we did something similar at ProMedica. I totally agree, co-designing it and co-designing it with your clinicians or your frontline folks. And it's not just frontline. You've got to be careful about how we define frontline. It's also your security team and your facilities team and those other stakeholders. But you have to co-design it for it to get sticky. I do think having an engaged workforce of physician leaders, future physician leaders, is super important. Our group, they named themselves a transformer. So you guys had the catalyst and we had the transformer. Let's
SPEAKER_03:pull them together. I love that.
SPEAKER_01:Honestly, that's some power. And we were also very deliberate. We intentionally picked our younger providers who we just recruited. And I think normally... folks would go to those seasoned partners or their seasoned docs who'd been here for a long time. And those stakeholders were also included. It was still very important. But we wanted the young disruptors who had seen and seen things differently in other organizations who would challenge us and where it felt psychologically safe that they could challenge us. Otherwise, you don't get the buy-in because we have to be just as ready to learn and grow as much as we're asking them for their input in designing. So if you bring them all in to tell them what you're gonna do, I will guarantee you that would be your first step of failure. And you're not right anyway. There's 20 ways to do one thing. And so to allow yourself to not be right, to really facilitate really good conversations and let the innovation kind of organically happen, I think that requires some thoughtful design as we're talking about an engagement But it also means that we need to think about leadership development differently, and we need to think about succession planning differently. And really, what is your why behind the transformation? Where are you leading to? What are you trying? If you're trying to recreate your system, everyone wants to do something that's meaningful, that's valued, and where people feel useful and needed. If that's the goal of your organization, and I'm sure there are many different goals in your organization, then I guarantee you that there are people ready to run into that fire. I mean, I think, you know, different than COVID where I did feel responsibility and people were running into that fire, like as an administrator felt really a high degree of responsibility for asking people to do the hard work that they did. I don't feel any differently about asking people to do hard work today. It's just not a pandemic, right? So, um, We have workplace violence issues. We have burnout issues. We have all kinds of issues. So that same fire looks a little different today, but the challenges are still real and people want to do meaningful work. And I think in healthcare especially, we allow a platform for them to do meaningful work. You really can't ignite that passion and keep it.
SPEAKER_02:So often folks refer to AI and tech as the solution to all this. As you look out into the future, how quickly do you see the adoption rate being for AI and tech? And is it the answer to all this?
SPEAKER_01:Well, that's like saying EMR is the answer for every single charting issue, and we know that's not true. First of all, you can't ignore AI. I think about AI as far as automation, making work more efficient, making it smarter, being able to apply it on a broader network. I'm learning from some of the people who directly report to me and how efficient I can become because they're using AI more efficiently than I am at the moment. At ProMedica, we're using AI probably more cohesively and consistently in the clinical setting. But where I can see it having broader implications in the shared services world is automation with revenue cycle. So again, think about that consumer mindset, right? I want my bill correct, I want to reduce overhead, and I want to keep things efficient for that consumer as well as for your internal own expense structure. It's a great place to automate without really a whole lot of risk. In our legal team, they're looking at ways to look through forms and with defined criteria, be able to turn contracts over more quickly. To not reduce workforce, but to allow the work that our lawyers are doing to be a higher level of work using their critical thinking instead of just pushing papers. You know, going back to Terrell when he said taking that darn... piece of paper off the fax machine. Our poor lawyers, they talk about living in seas of paper, my word. So I think AI is absolutely here to stay. It's gonna be faster than we're all ready for, and I think we have to lean into it. And it's gonna be at the cultural pace that you're comfortable with for your organization. I think some people are gonna be fast leaders, Others are going to be fast followers, and then there's going to be the ones that just kind of wait to see what works. I don't think you can wait to see what works in this space. I think that you're going to be way too slow and miss all of the amazing opportunities to learn and how to apply it in your own organization. It can't just work by itself, though. You still need people. You still need all of us to make sure we're maximizing it ethically. you know, convening it, structure, governance of all of that, and how you're going to use it in your organization, there's still a huge responsibility. It's not just a cost savings, but it is going to make us better faster. I don't know what you think, Daryl.
SPEAKER_03:Oh, yeah, absolutely. I think when I hear, well, AI impact healthcare or the world, I think, well, did the computer impact the world? Did the internet impact the world? AI is not a narrow capability. It's like the internet. It starts touching everything very quickly. There will not be such a thing as an AI company in the future. There will be AI in everything. And so how do we harness that? A couple of points I would add, and I agree with your comments. One, for the first time, we have technology that can actually change healthcare. The old algorithmic kind of code it, and then the machine runs across the code and algorithmically tries to get a job done that's too complex, has not worked well in healthcare. And that's why healthcare has lagged in technology adoption so much, because some of our, especially clinical decision making, is not at all amenable to a coded solution. Now you have artificial intelligence, which is real intelligence. It is able to process and think in a way with a very high IQ and absorbing a massive amount of, can pass all the boards, nursing boards, pharmacy boards, physician boards. It can pass at a higher rate than your medical staff or your nursing staff. So then how do you do that? How do you use it? How do you start with low risk use cases as you've described, Angela? And then how do you grow toward higher risk use cases? And how do you make sure you don't jump too fast because that could be dangerous? Humans in the middle, as you said, I think very essential, but also the ability to augment humans in a way in a workforce shortage environment is essential. This is part of the answer to how a physician in the future can do one and a half times the work at a felt effort of 0.9. That's transformational. That starts to mean the shortage isn't what we thought it was because now we're using technology in more intelligent ways. The last point I'll make is the bad guys are going to use it fast. We don't have the luxury of saying, well, when it's safe, we'll use it. Well, guess what? Our attorney friends here, the trial bar is using it. They're gonna get ahold of the chart and they're gonna jam through that chart and they're gonna point out every single point where that physician of whatever specialty didn't follow evidence. And your resistance to AI will mean your organization is unable to counter. These are very serious dynamics. We have to figure out how to move forward at a reasonable pace because the adopters out there, yes, the cyber thieves and hackers are gonna use it, but legitimate entities like payers are gonna use it in harmful ways to health systems. Attorneys that are on the other side of cases will use it, et cetera. So I think we absolutely should keep up with them in health systems. We're doing good work. We deserve to keep up with them.
SPEAKER_01:You know, something you just said before we move on, sorry, Rob, just made me think, you know, my kids just got, I got notification from my kids. Well, actually they got it because I'm paying for their college, but it came to me, right? But all of their college courses are requiring them to use AI now at many of the universities. And so if you even think about the future workforce of a physician or a nurse, you know, they're going to be using it and training with it. So as an organization, you really are going to not be able to even attract top talent if you don't have an AI strategy at some point in time.
SPEAKER_03:So just- Great point. Same thing happened with the- With the EHR, right? Remember when the old school grads resisted any kind of electronic health record and now new grads would never work in a place that didn't have an effective medical record.
SPEAKER_01:You don't have robots to be operating on. You're not getting those surgeons, right? I mean, that's what AI is right now. That's what we're going to be dealing with from a workforce employee preference. It's just amazing.
SPEAKER_02:So we break down some of the barriers that we've got historically. We get our physicians and our providers to come along with us. We use technology well. Do all these things get you to be that successful health system of the future without a strong payer mix? When we look across the country now and the haves and have nots, if you are still struggling with your payer mix, how do you overcome all the other challenges?
SPEAKER_03:You know, Rob, I think the concept of a strong payer mix is declining everywhere. So take a high growth system, Fairly healthy pair mix market, say, in Texas or Florida, and you see the commercial insurance rates dropping in those markets. Those systems may not notice it yet because they still have plenty, but those commercially insured rates are dropping. What are they being replaced by? Self-pay, Medicaid, Medicare, Medicare Advantage. As we see that nationally, and then some markets in the U.S. are already there. And it's very, very challenging. But we've talked for years, maybe decades, about Medicare breakeven. Can systems operate at a level of cost that accommodates a lower level of reimbursement? There are two paths, I think, that help with that. One is using leverage, using technology leverage to reduce the total cost of our operation, of our production systems. We've not done that well in healthcare. Part of it is we've had enough buffers, enough, the not-for-profit advantage, right? The ability to not pay taxes and to have a 340B drug program that brings an extra margin that lets us get by. And so we don't, actually enforce a technology leverage strategy that starts to bring our cost structures down, like other industries really had to do because of the narrowness of their margins. So I think we really need to think as an industry about that. And this AI question from before is certainly part of that answer. And Value-based care is actually a strategy that when your per-click payment rates continue to decline, you start to realize that if we received payment differently and we could manage the total cost of care of a human being, if we could manage across a lifetime, if we could really feel a sense of ownership of that human being's thriving and their experience of health, not just healthcare, if we can get there as an industry, I think we can change the paradigm and we all have some strategies to do that. I think it's happened much more slowly than we would have expected. but it will be required. It will be required that we take a more longitudinal view of a human being, that we have access to the dollars upfront instead of so many of them being essentially filtered away through middle layers and through administrative structures and massive overhead that's grown 3,500% plus while the number of providers have grown 150% since the 70s. This is so out of line that in order to come back to a point of resilience and stability, I think we'll really, really have to pay attention to this in our redesign efforts.
SPEAKER_01:It's a wicked problem. Even as I'm hearing you talk about it, you know, I think about the consumer demands for certain clinical tests that provider might not even feel as medically necessary. And, you know, then there's a litiginous piece of that and making sure the I is dotted and T is crossed. It is a wicked trap right now for patients. healthcare providers. And I do think like a different payment methodology and having that payment up front, I still think there has to be something in it for the patient or the consumer. And so whether that's addressed as the employee benefit, or whether that's addressed on the individual basis, I don't know that I have that solution, despite the way you gave us the add on at the beginning there that we didn't have all the solutions. But I do think that it is a wicked problem. And it's multifactorial. It's not just a reimbursement problem. It is a care design issue as well. And we're going to have to figure out a way. There are systems figuring out a way now. I don't even know what a good payer mix is. I think we've gone on the whole, we can, well, and all volume is good volume. And then it was, I just need the right payer mix. And now it's like, I just need the right CMI or whatever. But ultimately, I think if you're documenting the care, you have the good value incentives incentivized, or excuse me, value incentives aligned, then you can do a good job, but you're going to have to embrace technology, automation, changing the workforce. It's all of those factors. There's not a silver bullet here.
SPEAKER_02:So off that theme, as we look again at that alleged health, successful health system of the future, is it going to be a scale play, which we know that's a common strategy where we're just going to see entities get large? I can remember a conference that Angela and I were at where Atul Gawande said in 2010 that every time you used to have a hardware store, Every time you used to have a hospital and that's not going to be the future, it's going to be big box, Home Depot and Lowe's. Is that where health systems are going? Or is it going to be something more vertically integrated where we're going to see pay riders or other industry segments come together in a successful collaboration? Are we going to see health systems partnered with other post-acutes or other segments of the industry? What do you both think just about how you would put those building blocks together?
SPEAKER_01:Scale always has advantages on some level, right? So I think there's still going to be big systems, but I personally wouldn't be surprised if you have more regional systems staying strong and independent as well as those big kind of systems. I don't know that one model is going to work. I think that based on the state, based on the reimbursement, based on the philosophies, the scale will get you so far. But at the end of the day, you have to be nimble enough to be able to adjust and change and pivot, pilot things, fail fast. And so sometimes, you know, being large can be a disadvantage in that regard. And so I don't know what you think, Daryl, but I think that there's advantages in being probably strong and regional or collaborating. Yeah.
SPEAKER_03:I think scale has been disappointing in healthcare, largely as systems have gotten large. Even the largest systems like HCA has 5% national market share. So there's no such thing as a national American healthcare system in the way that other categories of industry might think of scale. I do think there's a problem of subscale. capabilities and I think that there's this interesting opportunity ahead where regional networks can be created without aggregation without acquisition if your goal isn't to just go leverage the payer for maximum payment then you can get more creative you don't have to own the world you don't have to roll up all the health systems and go to Anthem and say we want the most we can get out of you but What if ProMedica and Summa Health and Altman created a distribution and supply chain system together? What if five systems in three states that were contiguous could get together and create a single workforce company that would become an outsourced HR department for all of those systems instead of every system having to replicate that? I think we have to think And we can seek scale. It's legal to do these things. They have to be appropriately structured. But we have to think about how we do things differently when we're underscaled. And we can achieve, I think, a lot of the economies of scale that a system like HCA might have without necessarily... being sold to a larger system or without having to seek the acquisition of 20 systems in order to make something meaningful happen. Somehow, the way American healthcare works is highly regional. It's highly designed for the cities and towns and stakeholders that exist within these circles of care, and it's very difficult to transmit capability. I came from a large system that operated in 10 states, and it was very difficult for us to achieve economies or advantages of scale across 10 states. states where we could. is in the single state where we had 23 hospitals. Well, then we could create warehouses, and we could run a large HR team, and we could do a lot of things that shared services, but that didn't help us in Chicago or Colorado. So I think as we think about the future of healthcare, we should think about how that contiguous support system gets created that reduces the total cost and allows us to hold the steering wheel instead of outsourcing those things, which I think is a hasn't been working well for systems that have tried it so far.
SPEAKER_02:So we talked about the role a bunch of different players may have in this transformation. Let's get to the role of our members, lawyers. As you've looked at lawyers that you've worked with throughout your career journeys, what would you suggest to our audience about the role that they could play in this transformative change?
SPEAKER_03:It is such a cool question, Rob. I have loved working with the attorneys that I've gotten to work with across my career. And they know that one of the things we often talk about together is, in fact, I remember one time sitting down with our chief legal officer and saying, I don't need you to be the goalie. I need you to be on offense with me. I need your help making the goal. We have to follow the rules of the game. I absolutely accept that. So we're following the rules of the game. We're skating together. We have the puck. We're going to shoot it at the goal. You're not the goalie. You're on offense. How do we get this done? When I've had those partnerships with attorneys that want to think that way, that want to think toward an architecture of the future, a way to get it done, there are so many more opportunities to succeed together than some twisted concept that... I'm probably a crook. And if you don't stand in the goal box, then I'm going to get something by you, right? Because I'm not. I'm not a crook. And most leaders aren't. Most leaders aren't. You'll spot them if they are, certainly. But most leaders aren't. They're just earnestly trying to build something better that works and that works within the regulatory framework that you have so well captured in your training. And that's a really important aspect of the work.
SPEAKER_01:Yeah, I agree with that wholeheartedly. The best legal teams I've worked with have been the, well, not that, but how about this? Like there's so many operational knowledge that lawyers have in the clinical operations that we respect you all for, but we just, please use your voices because you can help us reframe an idea, make it better. You know, I think additional innovation and partnerships or joint ventures or those collaboratives that Daryl was chatting about, those are huge because it's sometimes maybe an infancy of an idea. And a lawyer can help us design it in a way that makes it a better idea. I think also just continue to help us with this regulatory compliance and the changing regulations. I mean, that changes every day, right? But the complexity around that and in the future, the complexity around that, as we talked about with AI or data privacy or cyber, all of those things, you know, we're going to continue to need to be partners on. And that's how I see our legal team. They're our partners. And so the best help that I could ask is continue to be that because that's what we need from all of you is just to continue to be our partners and help us innovate. Look at everything you've done, Rob. I mean, with the joint ventures and the different arrangements. I mean, it's helped the system that you're part of be an amazing and better system. And so that's your trusted partner. And that's a huge asset.
SPEAKER_02:So as we wrap up, we've talked about being in crisis management in this industry for an extended period of time. One of the things that always helps the workforce in crisis management is hope. What are your parting words of hope to the healthcare workers out there that may be listening today?
SPEAKER_01:Well, I would think I would like to just say I do have hope. I'm really proud to work in this industry. I'm really proud to work with challenging situations where people at their most vulnerable moments come to us for care. So I don't know if there's any higher level of privilege that you can be afforded. So if that isn't inspiring and doesn't elicit hope, then you probably aren't in the right industry. But nevertheless, what you do matters. And take a deep breath. Slow down. It's gonna be okay. Yeah, it's crazy. We all have our days, but this is actually what change feels like. And change is the only thing that's constant. So buckle up. Here we go.
SPEAKER_03:I'm ready. I'm ready to go. I love that. What a rallying cry. And that recognizes the fact that healthcare is hard work. It's a difficult, heroic career choice. and it requires people who know it will be that way their whole career. there is nothing that fixes the challenge of being a police officer or a paramedic or a firefighter. The same thing is true in healthcare. There's nothing that fixes how hard it is to do heroic, life-changing work every single day. So to me, hope is not defined as we are going to someday make this career easy for you. I think hope is defined exactly around the purpose that Angela described. We have a purpose. We run toward the danger, the risk, the challenge. We run toward the challenge. Our communities need us. We are an asset to them. And every single day, to me, hope is created by fighting for better, fighting for better. And that fight will always be incremental. I will end my career having fought for better every day and not accomplish a long list of things I wish I would have accomplished. The same is true for you, every single person listening. And And you'll hand off the mantle and the next person will take that up and they will fight their entire careers. And every single moment you make incremental progress or sometimes transformational progress, I think that spark is created. And that's where hope is, our hope to be better. We are purpose-driven and we are getting better every day. And even on those days you can't see it, it's still happening. And I think we need to tell those stories better and better. So
SPEAKER_02:sometimes they say right person at the right time. Thank you, Angela. Thank you, Darrell, for coming along at the right time for our membership. I know there's been a lot of folks struggling with all this change, but your words today were really inspiring and appreciate you taking time to share with our members.
SPEAKER_03:Thanks
SPEAKER_02:for that. Thank you, Rob.
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